Oral Rehydration Salts (ORS)

On July 29, a notification on my cellphone read ‘Today is the World ORS Day.’ When there is a Left Handers’ Day (August 13,) a Sandwich Day (November 3,) a Puppy Day (March 23,) and also a Nothing Day (January 16;) I wasn’t surprised to find an ORS day!

ORS Day is observed each year on July 29 to emphasise the importance of ORS as an affordable and highly impactful healthcare method to treat dehydration and diarrhea. This year too it was celebrated, but without much fanfare, throughout the world.  I have failed to find the significance of the date – July 29 – connecting to ORS. Hence I decided to dwell a bit deep.

For more than 25 years WHO and UNICEF have recommended a single formulation of glucose-based ORS to treat or prevent dehydration from diarrhoea and cholera for all ages.  ORS has been used worldwide and has contributed substantially to the dramatic global reduction in mortality from diarrhoeal diseases.

ORS is an oral powder–containing mixture of glucose, sodium chloride, potassium chloride, and sodium citrate. After dissolving in requisite volume of water, it is used for the prevention and treatment of dehydration, especially due to diarrhea.

ORS and zinc are recommended by the WHO and UNICEF to be used collectively to ensure the effective treatment of diarrhea. ORS replaces the essential fluids and salts lost through diarrhea.  Zinc decreases the duration and severity of an episode and reduces the risk of recurrence in the immediate short term.

Captain Robert Allan Phillips (1906–1976) of the US Navy in 1946 first successfully tried oral glucose saline on two cholera patients. As a Navy Lieutenant at the Rockefeller Institute for Medical Research during World War II, Phillips developed a field method for the rapid assessment of fluid loss in wounded servicemen.  Captain Phillips embarked on cholera studies during the 1947 Egyptian cholera epidemic and developed highly effectives methods of intravenous rehydration. Later he developed a of glucose-based oral rehydration therapy.

The typical Indian Jugaad  (जुगाड़) by Dr Dilip Mahalanabis – a paediatrician and a clinical scientist working with Johns Hopkins University Center for Medical Research and Training (JHCMRT) – who treated multitudes of Bangladeshi refugees who were suffering from diarrhea with rehydration salt sachets or ORS.  He has not received any recognition, either from the international community or from the Indian government.

Oxford Dictionary defines Jugaad as ‘A flexible approach to problem-solving that uses limited resources in an innovative way.’  In effect, there is no real word in English that captures the essence of the real Jugaad

In 1971, an estimated 10 million refugees crossed the border from East Pakistan into India as per UNHCR.  This was the largest single displacement of refugees in the second half of the 20th century.  The refugees were severely malnourished, especially the children and the Indian government took all efforts to take care of the refugees, despite meager support from the international community.

After walking long distances on foot to escape from the ruthless atrocities of the Pakistan Army, this starved and frightened mass of people sought refuge in India. A cholera outbreak in the refugee camps badly affected the already exhausted and starved refugees.  The monsoon was in full fury, and for the refugees living in tents and other make shift arrangements, it was hell.  It is estimated that about 30% of the refugees died from cholera and diarrhea.

This called for a huge amount of intravenous fluids and coupled with problems of transport and lack of trained personnel for their administration, effective treatment was near impossible.  Dr Mahalanabis suggested use of oral fluids as the only recourse in this situation.  He recommended an electrolyte solution with glucose which could prevent fatal dehydration.

The ORS recipe he used consisted of 22 gm glucose, 3.5 gm table salt and 2.5 gm baking soda per liter of water. This is the simplest formula, containing the minimum number of ingredients, that saved the day for many refugees and they lived to narrate the horrors they faced.

He organised two teams for cholera therapy including oral rehydration. Both teams worked along the border between India and Bangladesh.  He established a treatment centre at the sub-divisional hospital in Bongaon with 16 beds.  He organised  a continuous shuttle of vehicles on the 80 km run from Calcutta to Bongaon, carrying personnel, medication, food and supplies to the centre.  The reserves of intravenous saline-lactate solution stocked originally for cholera research soon depleted.   He had to now used Juggad to make ORS.

To make the ORS, glucose-and salt packets were prepared in Calcutta; first in the JHCMRT library room. Each of the three components of the mixture were carefully weighed by separate technicians and poured into a small polyethylene bag in an assembly-line fashion. Another technician inserted a descriptive label with instructions for dissolving in water; then he sealed one end of the bag with a hot iron. In the field, the dry powder was added to clean drinking water and dispensed from drums directly into the patients’ cups.  The cost was calculated to be 11 Indian paise, (about 1.5 US cents) then per liter of fluid.

Later in 1978 during the cholera epidemic in Manipur, ORS was extensively used, especially in children with diarrhea and cholera. The WHO in 1978 launched the global diarrhea diseases control program with ORS.  In 1979 WHO approved ORS.

Today, ORS is included in WHO’s Essential Medicines List, and Priority Medicines for mothers and children. ORS is also listed as a lifesaving commodity identified and targeted for scale-up and access by the UN Commission on Life-Saving Commodities for Women and Children.

India faced a dire financial situation after the 1971 Indo-Pak war and taking care of the refugees.  To shore up some money, the Government of India applied Jugaad and imposed the Refugee Relief Tax (RRT) throughout the country that came into force on November 15, 1971. It meant a separate five paisa stamp to be affixed on all postal articles to show payment of the tax.

The post offices immediately applied Jugaad and came up with hand-stamps marked ‘Refugee Relief Tax Prepaid in Cash’ on all postal stationery.  On December 1, 1971 the new five paisa stamp, showing an image of a refugee family fleeing persecution was released. RRT was repealed in effect from April 1, 1973.

Women at the National Defence Academy (NDA)

India’s Supreme Court on August 18, 2021, allowed women candidates to appear for NDA entrance exam scheduled on September 5, saying debarring them amounted to gender discrimination.

There has been a raging debate over the judgement among the Veterans community, with many voicing against the court ruling.  Some passed some scathing attacks on women while some came out with interesting memes and jokes.

Some questioned the physical abilities of Lady Cadets.  One theorised that the larger number of cases of stress fractures among Lady Cadets in comparison to their male counterparts was attributed to the difference in bone structure of women that the female hips are not meant to take the same stress as males because they have widened pelvis to enable child bearing.

With all these inputs, I decided to study the Royal Military College of Canada (RMC), the military college of the Canadian Armed Forces and, since 1959, a degree-granting university training military officers.  Like the NDA, the RMC mission is to educate, train and develop Officer Cadets for leadership careers of effective service in the Royal Canadian Air Force, the Royal Canadian Navy and the Canadian Army.

RMC opened its doors for the Lady Cadets in 1980.  The program introducing female cadets has worked well, mainly because the move was carefully planned, integrating both men and women. Lady Cadets are required to maintain the same exacting standards as Gentleman Cadets. They run the same obstacle course – a mandatory ordeal for which first-year recruits earn the right to wear the RMC uniform. They also compete in mixed inter-squadron sports.

2.4km Run – The Aerobic Component.   This portion consists of running 3 laps of an 800m course in the fastest time possible. 

Push-ups – The Upper Body Muscle Endurance Component.  During the test the candidates are required to perform their maximum push-up repetitions. There is no time limit and the push-up execution must comply with the Canadian Armed Forces push-up protocol

Agility Run – The Speed Component.  This test consists of sprinting 6 x 9 m by weaving around four obstacles (chairs) without touching any of them. Two trials are permitted and the best result is compiled. 

Sit-ups – The Mid-core Muscle Endurance Component.   This test consists of a two minute evaluation during which the candidates must perform their maximum repetitions of sit-ups according to Canadian Forces protocol. 

Standing Long Jump – The Leg Power Component.  The candidates are required to jump from both feet without hopping. Two trials are permitted and the best result is compiled.

RMC Physical Performance Test (RMC PPT.)  As part of the program, the students are being physically assessed two times a year. The completed evaluation is being scored out of 500 points where each item is worth a maximum of 100 points. A minimum of 250 points is required to successfully complete the RMC PPT. Five physical fitness components are evaluated through different testing items: the 2.4km Run, push-ups, agility run, sit-ups and a standing long jump.

 Male Female
Agility Run17.8 sec15.2 sec19.4 sec16.2 sec
Standing Long Jump195 cm277 cm146 cm229 cm
2.4km Run10:347:5812:129:05

Fitness for Operational Requirements of CAF Employment (FORCE) Evaluation

The FORCE Evaluation is a reflection of the CAF minimal physical employment standard related to common defence and security duties known as the Universality of Service principle, which stipulates that “CAF members are liable to perform general military duties and common defence and security duties, not just the duties of their military occupation or occupational specification.

FORCE was developed by experts who looked at more than 400 tasks performed by CAF personnel in all environments over the past 20 years. Using the data collected from CAF personnel, subject matter experts, laboratory and field measurements, the research team developed a revised fitness component of the minimum operational standard required based on the following six common tasks:

  • Escape to cover.
  • Pickets and wire carry.
  • Sandbag fortification.
  • Picking and digging.
  • Vehicle extrication.
  • Stretcher carry.

Some trades within the CAF require higher levels of fitness or operational readiness, but the minimum standards for the FORCE Evaluation are meant to reflect the baseline CAF physical employment standard that everyone must meet.

The FORCE Evaluation is designed to capture the movement patterns, energy systems, and muscle groups recruited in the performance of the Common Military Task Fitness Evaluation (CMTFE).

The FORCE evaluation comprises of three sections, which are as follows:

  • A health appraisal questionnaire where the candidates complete a health appraisal evaluation and the evaluator records vitals (heart rate and blood pressure).
  • An operational fitness evaluation. Four job related simulations are evaluated during the FORCE evaluation.
  • An exercise prescription where the evaluator provides the candidates with a program detailing the activity frequency, duration, intensity and rate of progression.

The FORCE Evaluation consists of four test components, each designed to measure different physical capabilities:

  • Sandbag Lift:   30 consecutive lifts of a 20 kg sandbag above a height of 91.5 cm, alternating between left and right sandbags separated by 1.25 m. Standard: 3 min 30 sec Intermittent
  • Loaded Shuttles:  Using the 20 m lines, complete ten shuttles (1 shuttle = 20 m there, 20 m back), alternating between a loaded shuttle with a 20 kg sandbag and an unloaded shuttle, for a total of 400 m. Standard: 5 min 21 sec 20-metre
  • Rushes:  Starting from prone, complete two shuttle sprints (1 shuttle = 20 m there, 20 m back) dropping to a prone position every 10m, for a total of 80 m. Standard: 51 sec
  • Sandbag Drag:  Carry one 20 kg sandbag and pull four on the floor over 20 m without stopping. Standard: Complete without stopping
  • If a member has not met the minimum fitness standards, a re-test can be attempted three months later.

Isn’t it high time the Indian Armed Forces take a re-look at the Physical Standards requirements for its cadets and recruits, considering women making their entry at all levels?

It may be pertinent for those in power and the Veterans to read The Stone Frigate: The Royal Military College’s First Female Cadet Speaks Out by Kate Armstrong, one of 32 women to first enter RMC in 1980 and graduate four years later. Her memoir captures the dominating, misogynistic world of one of Ontario’s most patriarchal institutions and her experience challenging it. 

It’s Natural, Biological and Not the Stork

In the Netherlands, Germany and eastern Europe the myth is that the storks nesting on the roof of a household were believed to bring good luck — and the possibility of new birth — to the family living below.

Marina broke the news of her pregnancy to our daughter, “There is a little baby growing in my belly and we will have a baby in March.”

How did the baby get into your belly and how old is the baby now?” asked inquisitive five-year-old Nidhi.

The God placed the baby in my belly and is three months old,” replied Marina.

I did not see the God in our home, but Dad came home four months back from his military post in Sikkim.  Whatever it is, I want a sister and not a brother as boys are bullies,” said an innocent Nidhi.

How to break the news of a sibling’s arrival to a child?

Young children are not geared to handle a lot of information about conception and childbirth.  Hence, breaking such a news got to be straight and simple and be ready to answer the questions that may follow.  Never pre-empt the child with your explanations, wait for the child’s questions.  If the child is not asking any questions, then it is not n his/her mind.  If the child asks more questions, then by all means go into more detail.

A good method is to make your explanation into a story on the lines that Mom and Dad make a baby, the baby grows inside Mom’s belly, and the baby comes out when fully developed after ten months.  Always ask a few probing questions to determine your child’s level of understanding of pregnancy is all about.  This will help you to choose your words.  You can begin with the fusion of the sperm and an egg in the way fruit grows from a seed.  You can also explain as to how the child develops, its movements, how it feeds, how it sleeps, etc.  If your child is school going, you can ask a few questions to find out what they already know about where babies come from and then follow their lead.  Ensure that you use accurate anatomical language like womb or uterus instead of belly, etc.

Here comes the importance of using accurate anatomical terms for our body parts, especially the private parts.

Most of us grew up with funny sounding names for our private parts – tuckus, tush, peepee, peekki and so on.  Our parents do it for the sake of propriety and also, they wanted to save themselves from embarrassment.  Imagine a kid screaming in a busy shopping mall “My penis hurts!” or “My vagina is itching!!”

It is neither an embarrassment nor a stigma.  It becomes so only if you visualise it to be so.  The proper names for their genitals – penis, testicles, vagina, vulva are taught in Canada in Grade 1 as per the new sexual health education curriculum.  By giving alternative names for our private body parts, we are doing a lot of disservice to our kids.  It has to begin at home and our kids should not be surprised at school.  A study found that kids who easily understood to the terms were the ones who used the proper names for their body parts at home with their parents.

It helps children develop a healthy, more positive body image, instead of feeling that their genitals are something shameful or bad.  It also facilitates the children to understand their bodies better and will prompt them to ask questions about sexual development.  Teaching kids the proper terms for their body parts enhances their awareness of their body, positive body image, self-esteem and confidence.

Kids who are comfortable talking about their bodies are more likely to be able to disclose when something worrisome or uncomfortable is happening to them. They can explain confidently to the doctors about their problems like itching or pain in their private parts.  They can also inform their parents when someone touched them inappropriately. 

Child-sex predators are less likely to pick confident, informed kids who obviously talk openly with their parents about their bodies, and who are aware that other people touching their private parts must be stopped and any attempt reported to the parents immediately.

A study found that even though kids in pre-school learn the proper names for their body parts, only kids with parents who used the right terms caught on. So, do not leave this important task to the teachers. You can begin using proper terminology when changing diapers, bathing the child, or at any other time that the subject might come up.

Sex education must begin at home, and it has to be age appropriate.  You may seek the assistance of your pediatrician.  Many of us are uncomfortable with the use of anatomically correct terminology; hence it is important to practice before you talk with your kids.  If they sense that you are uncomfortable, it will never sink in.  Every question from your child about his or her body must be answered as appropriate to the child’s age, as accurately and honestly as possible. Never make it a big deal!!!

For me, my first sex education teacher was my Amma and to read more about it, Please Click Here.

These are two well illustrated books I recommend for parents and grandparents.  The books will help you answer young children’s delightful, thoughtful, and often non-stop questions about their own bodies and about how girls’ and boys’ bodies are the same and are different questions that are seemingly simple, but often not easy to answer. 

Mr M Selvaraj on his Protege Veteran Vice Admiral Ashok Kumar

To read more about Mr M Selvaraj, Please Click Here.

When our Amaravian Colonel Reji koduvath Roll No 931 of SSA, wanted me to share my experience with Vice Chief of Naval staff Vice Admiral G Ashok kumar, an Amaravian I readily accepted heart of hearts, though I didn’t give a positive nod to him on the spot. How can a teacher say ‘No’ when he is asked to say about his student in the past during his formative years in Sainik School, Amaravathinagar. As I am an ardent lover of Reji’s prolific pen who is an author of two books in addition to many blogs penned by him about Masters of SSA.

Since over lapping memories for the past more than four decades give pressure to my thoughts, joining with my age, minute details of our Vice Admiral Ashok Kumar had escaped from my memory.

In the year 1971 Ashok kumar Roll No 870 joined as a raw-clay along with other students like 892 Brigadier T Thomas, Colonel Reji Koduvath and many others. In the process of moulding the cadets through well–designed activities, he made a remarkable lead and made himself fit physically, mentally, intellectually and emotionally for joining the National Defence Academy and other walks of civil life.

Blue colour epaulets with single golden stripes adorned Ashok’sshoulders when he was in eleventh standard as he was made Vice Captain of Chera House by selection and not by election. He was a front line cadet both in scholastic and co-scholastic areas. He lead the Chera House under the guidance of his House Master Mr MV Somasundaram, a nonagenarian, now living in Chennai, ably assisting his House Captain, marched forward majestically towards achieving the target of hugging the covetable Cock-House trophy and to give honour to his House symbol Bow and Arrow.

As all Sainikiens are groomed to become all rounders, he enthusiastically participated in all activities. If my memory track is in the right direction, he was a good basket ball player, a fine tune piper in the school band, ably guided by the Band Master Mr Goodu Sahib. His most liked area is on the stage. He is blessed with the gift of the gap and with his eloquent tongue he enjoyed and made the audience enjoy with elocution and extempore speech competitions also conducted in the school intra-murally.

Group Photo of the Play on Ramanujan- Extreme Left : Mr K Ekambaram as Ramanujan, Vice Admiral G Ashok Kumar as Komalambal (Mother of Ramanujan), Late Mr KM Koshy as Professor Hardy, Mr Venkatesha Murthy as Collector of Nellore, Mr M Selvaraj as Father of Ramajujan, Late Mr AKR Varma as the Postman, Mr R Subramanium as Professor EH Neville (Photo Courtesy Mr Venkatesha Murthy).

As we are living in a nuclear family, if the parents don’t have girl child they need not worry, SSA will turn them to be beautiful girl in stage one- act plays. Yes, our Vice Admiral, G Ashok kumar, the then Sainikien is an example as he acted in a lady character, Komalambal, the mother of Ramanujam, world- wide great Indian Mathematician, in a skit entitled Ramanujam, written and directed by Mr Venkatesahamurthy, Maths Master. In addition to students, many Masters like Mr KM Koshy,Mr R Subramanan, Mr K.Ekambaram,Mr KP Nataraja Pillai, Mr King Kristo kumar, myself and the playwright Mr Venkateshamurthy himself enacted various roles.

Right from his joining the SSA Ashok had been a gentleman cadet, the way in which he was moving with his fellow mates, Masters, other staff members and the armed force officers were of exemplary manner and that he was loved by all.
He is one of the proud sons of Alma mater SSA , and he has reached the second highest position in the Indian Navy. Normally intelligent people make a soft- pedaling towards intelligence; but our Admiral Ashok kumar is an exemption. If I say that his intelligence coupled with diligence has taken him to such a great height along with other covetable traits in him , it is not an encomium or a hyperbole but it is my heartfelt expression that comes from the bottom of my heart about our past student of Sainik School Amaravathi Nagar, Vice Admiral and Vice Chief of Naval staff.

On behalf of all Amaravians – Defence officers, Masters, Staff members and the students of the past and present let me wish Vice Admiral Ashok kumar, his better half, Mrs Geetha, the woman behind him for his achievement and success, daughters Mrs Sruthi and Ms Sweta all the best. May God’s gracious blessings be showered on them.

Rohint Natarajan on Veteran Vice Admiral G Ashok Kumar

The first time I met Ashok Uncle was when I was about 8-9 years old, when we had gone to Darjeeling and Gangtok on a family vacation. We were staying at the officers’ mess at Gangtok. Dad suddenly walked in with a smart energetic gentleman and introduced him as his classmate. They both were overjoyed to see each other. Little did I know back then that our association would stretch so long in our life. Because as an army kid you come across so many coursemates and uncles every now and then. But the strong bond that Sainik School Amaravati Nagar had forged held on stronger than anything.

Many years down the line, I kept on hearing about uncle and as luck could have it, both Ashok Uncle  and my dad were posted at Mumbai at the same time. I used to hear that dad used to go meet uncle often despite him holding a prestigious and demanding position. Owing to the fact that I was elsewhere during that tenure I could not get a first hand glimpse of how Ashok Uncle handled his multitudes of roles with such aplomb.

When we went to NDA as a part of the Amaravians get together in 2015, I got to see Ashok Uncle’s cool side. He must have probably been the coolest of all commandants of NDA, his alma mater as well. Finally, in 2019 when we were at Delhi and Ashok Uncle was yhe Vice Chief of Naval Staff (VCNS,) I had probably maximum interaction with him compared to any of his batchmates kids. I am thoroughly convinced that he is the most chilled out person who is always high on energy and ever cheerful; that too while being the VCNS.

Not to forget Geeta Aunty is also retiring with uncle, who is also another one who needs to be mentioned for her cool demeanor. Perfect couple who are always youthful and full of life. I have never seen either of them stressed or tensed despite the numerous tasks and responsibilities at hand. He was kind enough to share few instances of how he had managed to wriggle out of tough spots while ensuring that no one’s ego was hurt and at the same time ensuring the outcome was the best possible one.

It is simply unbelievable. The quick thinking, speed of thought and execution is something I wish to emulate in my life as well. I think I have iterated enough number of times how cool uncle is but it just does not seem enough. It would be incomplete if I don’t mention his amazing singing skills. Oh what a wonderful entertainer he is!! Would have given so many singers in the industry a run for their money. Good for them that he ended up in the Indian Navy.

All the very best Ashok Uncle for your second innings. I’m sure the nation is missing out on an amazing chief of Indian Navy but hopefully he gets to serve in some or the other capacity because he still has enough fire in his belly. Also the nation needs such leaders. Good luck Ashok Uncle and Geeta Aunty. Lots of love yours truly Rohinth (Gucci as Aunty calls me.)

About Rohint Natarajan: – Born in Tiruppur to Veteran Brigadier TM Natarajan, an Amaravian of 79 batch and Mrs Sudha Natarajan. He travelled the length and breadth of the country as an Army Kid. An alumnus of almost 10 educational institutions across the country – Army public school Dhaula Kuan, New Delhi and Kolkata, Bhavans Secunderabad, Kendriya Vidyalaya , Avadi to name a few. A mechanical engineering graduate from SASTRA University, Thanjavur (completed in 2014.)

After a short stint in Tata Consultancy Services, joined the Central Reserve Police Force as Assistant Commandant in 2017 and served at the Indo Pak border in the Kutch Sector. Subsequently, cleared Civil Services Examination in 2018 and joined Indian Revenue Service (Income Tax.) Presently serving as assistant commissioner in Bangalore.

Interests include traveling, playing the guitar, sports and watching movies.